RT Journal
A1 Patti G, Pasceri V, Di Sciascio G
T1 STandard- vs high-dose clopidogrel after percutaneous coronary intervention
JF JAMA
JO JAMA
YR 2011
FD June 22
VO 305
IS 24
SP 2520
OP 2522
DO 10.1001/jama.2011.843
UL http://dx.doi.org/10.1001/jama.2011.843
AB 
In the hours following PCI, there is a significant increase in platelet reactivity due to procedural platelet activation, as described in the prospective Antiplatelet therapy for Reduction of Myocardial Damage during Angioplasty—Bleeding (ARMYDA-BLEEDS) study.2 Thus, measurements of platelet reactivity performed early after PCI may not reflect the baseline individual response to antiplatelet agents, and the first hours after PCI (as in GRAVITAS) may not represent the optimal time to measure platelet reactivity to determine antiplatelet therapy. In the ARMYDA–Platelet Reactivity predicts Outcome (ARMYDA-PRO) study,3 no relationship was observed between platelet reactivity during clopidogrel therapy measured at 8 and 24 hours after PCI and the risk of 30-day major adverse cardiac events. Similarly, there was a lack of correlation between enhanced response to clopidogrel, evaluated at 8 and 24 hours after coronary stenting, and in-hospital bleeding complications.2 Conversely, in the ARMYDA-PRO and ARMYDA-BLEEDS2- 3 studies, pre-intervention measurement of on-treatment platelet reactivity better predicted the risk of major adverse cardiac events for low responders and the risk of bleeding for hyperresponders.